The Pharmacist Option: Leveraging NL Pharmacists for More Effective Health Care Delivery

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1 The Pharmacist Option: Leveraging NL Pharmacists for More Effective Health Care Delivery

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3 An Economic Footprint of the Community Pharmacy Sector in NL* Community Pharmacy is a unique sector, providing health care in a retail setting It contributes to the province in multiple ways, including: Access to health services Job creation Significant direct contribution to the economy plus spillover effects Ratio of direct GDP high compared with other sectors *Pending Report from the Conference Board of Canada, numbers estimated

4 An Economic Footprint of the Community Pharmacy Sector in NL* Direct Impacts $137.6M in GDP (6.9% of provincial health sector GDP) Employs approximately 3000 residents Generates $111.5M in labour income With Indirect and Induced Impacts Added Total economic contribution $254M An additional 1310 jobs in province and rest of country In addition, the pharmacy sector in NL generated $25.2M in fiscal benefits to all levels of government in 2016, with about 79% of that amount occurring in our province *Pending Report from the Conference Board of Canada, numbers estimated

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7 The Evolving Role of the Pharmacist The scope of practice for a professional includes the activities he or she is educated and authorized to perform. Benefits of Expanded Scope: Health system savings by reducing costs associated with unnecessary doctor and emergency room visits. Improving health outcomes for patients. Pharmacy Dispensing Only

8 Scope of Practice 2012

9 Scope of Practice 2016

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12 POLYPHARMACY IN CANADA How many Canadians ( 65yrs) consume: 5 medications? 10 medications? (CIHI 2014)*

13 Costs of Medication Non-Adherence $14 BILLION estimated annual cost of medication non-adherence to the Canadian healthcare system These costs include such things as additional physician visits, extra laboratory tests, additional drug therapy, hospital ER visits, hospital admissions Ways to Increase Compliance Balkrishnan R. The importance of medication adherence in improving chronic-disease related outcomes: what we know and what we need to further know. Medical Care 2005;43(6): DiMatteo MR. Variations in patients adherence to medical recommendations: a quantitative review of 50 years of research. Medical Care 2004; 42(3):

14 Compliance Packaging From this

15 Compliance Packaging to this.

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17 Treatment of Minor Ailments (Whittington, Z. et al., Community Pharmacy Management of Minor Conditions the Care at the Chemist scheme, The Pharmaceutical Journal, 266 (March 31): )

18 Treatment of Minor Ailments Studies have shown that minor ailments comprise up to 40% of GP office visits Increased demands on family physicians, which could be alleviated if other qualified health professionals took on responsibility for less complex issues with patients Yadav, S. Pharmacists rather than GPs should be first contact for minor ailments, report says. BMJ 2008; 337:a775. Retrieved from Pumtong S, Boardman HF, Anderson CW. A multi-method evaluation of the pharmacy first minor ailments scheme. Int J Clin Pharm 2011; 33(3): DOI: /s National Physician Survey Br J Gen Pract Jul; 63(612): e472 e481. Published online 2013 Jul 1. doi: /bjgp13X669194

19 Treatment of Minor Ailments Conditions which can be treated by pharmacists Dyspepsia (indigestion) GERD(acid reflux) Nausea Non-infectious Diarrhea Hemorrhoids Allergic Rhinitis Cough Nasal Congestion Sore Throat Mild Headache Minor Muscle Pain Minor Joint Pain Minor Sleep Disorders Dysmenorrhea Emergency Contraception Xerophthalmia (dry eyes) Oral Ulcers Oral Fungal Infection (thrush) Fungal Infections of the Skin Vaginal Candidiasis (yeast infection) Threadworms and Pinworms Herpes Simplex (cold sores) Contact Allergic Dermatitis Mild Acne Mild to Moderate Eczema Mild Urticaria Impetigo Dandruff Calluses and Corns Warts (excluding facial and genital) Smoking Cessation

20 Improving Health and Lowering Costs Benefits of Pharmacist Care in Hypertension in NL Groundbreaking 2017 study shows significant health care dollars saved with pharmacists providing full scope of care for NL patients with hypertension Study shows: $335,000,000 saved over 30 years 2851 fewer strokes 5645 fewer heart attacks 1630 fewer cases of angina 1494 fewer instance of heart failure 39 fewer instances kidney failure An additional 20,000 years lived Cost-effectiveness of pharmacist care for managing hypertension in Canada, appears in the Canadian Pharmacists Journal and was authored by Carlo Marra, PharmD, PhD; Karissa Johnston, MSc, PhD; Valerie Santschi, PharmD, PhD; and Ross T. Tsuyuki, BSc(Pharm), PharmD,MSc, FCSHP, FACC.

21 The Value of Expanded Pharmacy Services in Canada Expanding three community pharmacy services (smoking cessation, advanced medication review and management for cardiovascular disease, and pneumococcal vaccination) could lead to cumulative savings between $2.5 billion and $25.7 billion over the next 20 years. Scaling up advanced medication review and management for cardiovascular disease could generate cost savings between $1.9 billion to $19.3 billion. Population health benefits of expanding these services include avoiding cases of chronic disease and premature deaths.

22 Prescribing in Collaborative Practice Better care, increased efficiency Regulations drafted to prescribe in collaborative practice

23 Summary Points Pharmacists can and want to play a bigger role in healthcare delivery Leveraging the skills and expertise of all health professionals is vital for meaningful change To create a healthcare system that is responsive, efficient and effective in improving the health of the people of NL requires innovation and the willingness to do things differently

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